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Form No.

49A
Application for Allotment of Permanent Account Number
[In the case of Indian Citizens/Indian Companies/Entities incorporated in India/
Unincorporated entities formed in India]
Under section 139A of the Income Tax act, 1961
To avoid mistake (s), please follow the accompanying instructions and examples before filling up the form
Assessing officer (AO code)
5
Sir,
I/We hereby request that a permanent account number be allotted to me/us.
I/We give below necessary particulars:
1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/date of birth/address documents: initials are not permitted)
Please select title, as applicable Shri Smt. Kumari M/s
Last Name / Surname
First Name
Middle Name
2 Abbreviation of the above name, as you would like it, to be printed on the PAN card
3 Have you ever been known by any other name? Yes No (please tick) as applicable)
If yes, please give that other name
Please select title, as applicable Shri Smt. Kumari M/s
Last Name / Surname
First Name
Middle Name
4 Gender (for Individual applicants only) Male Female (Please tick as applicable)
5 Date of Birth/Incorporation/Agreement/Partnership or Trust Deed/ Formation of Body of individuals or Association of Persons
6 Father's Name (Only 'Individual' applicants: Even married women should fill in father's name only)
Last Name / Surname
First Name
Middle Name
7 Address
Residence Address
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub- Division
Town / City / District
State / Union Territory Pincode / Zip code Country Name
Office Address
Name of office
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub- Division
Town / City / District
State / Union Territory Pincode / Zip code Country Name
8 Address for Communication Residence Office (Please tick as applicable)
Range code
R J N
AO No.
Day Month Year
Area code AO type
W 5 9 0
INDIA
INDIA
Sign/ leftTumb impression across this
photo

KAMAL PAREEK 09414332673

9 Telephone Number & Email ID details
Country code Area/STD Code Telephone / Mobile number
+ 9 1
Email ID
10 Status of applicant
Please select status, as applicable Government
Individual Hindu undivided family Company Partnership Firm Association of Persons
Trusts Body of Individuals Local Authority Artificial Juridical Persons Limited Liability Partnership
11 Registration Number (for company, firms, LLPs, etc.)
12 In case of a citizen of India, then
Please mention your AADHAAR number (if allotted)
13 Source of Income Please select status, as applicable
Salary Capital Gains
Income from Business / Profession Business/Profession code [For Code: Refer instructions] Income from Other sources
Income from House property No income
14 Representative Assessee (RA)
Full Name (Full expanded name: initials are not permitted)
Please select title, as applicable Shri Smt. Kumari M/s
Last Name / Surname
First Name
Middle Name
Address
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub- Division
Town / City / District
State / Union Territory Pincode
15 Documents submitted as Proof of Identity(POI) ,Proof of Address (POA) and Proof of Date of Birth
I/We have enclosed as proof of identity,
as proof of address and as proof of date of birth
[Please refer to the instructions (as specified in Rule 114 of I.T. Rules, 1962) for list of mandatory certified documents to be submitted as applicable]
16 I/We , the applicant, in the capacity of
do hereby declare that what is stated above is true to the best of my/our information and belief.
Place
D D M M Y Y Y Y
Date 2 0 1 4
pareekadvocate@gmail.com
Signature / Left Thumb Impression of
Applicant (inside the box)
Full name, address of the Representative Assessee, who is assessible under the Income Tax Act in respect of the person, whose particulars have been given in the column 1-
13.
[Annexure A, Annxure B & Annexure C are to be used wherever applicable]
SURATGARH

KAMAL PAREEK 09414332673


KAMAL PAREEK 09414332673


KAMAL PAREEK 09414332673

Form No. 49AA
Application for Allotment of Permanent Account Number
[Individuals not being a Citizen of India/Entities incorporated outside India/
Unincorporated entities formed outside India]
Under section 139A of the Income Tax act, 1961
To avoid mistake (s), please follow the accompanying instructions and examples before filling up the form
Assessing officer (AO code)
Sir,
I/We hereby request that a permanent account number be allotted to me/us.
I/We give below necessary particulars:
1 Full Name (Full expanded name to be mentioned as appearing in proof of identity/address documents: initials are not permitted)
Please select title, as applicable Shri/Mr Smt/Mrs Kumari/Ms M/s
Last Name / Surname
First Name
Middle Name
2 Abbreviation of the above name, as you would like it, to be printed on the PAN card
3 Have you ever been known by any other name? Yes No (please tick) as applicable)
If yes, please give that other name
Please select title, as applicable Shri/Mr Smt/Mrs Kumari/Ms M/s
Last Name / Surname
First Name
Middle Name
4 Gender (for Individual applicants only) Male Female (Please tick as applicable)
5 Date of Birth/Incorporation/Agreement/Partnership or Trust Deed/ Formation of Body of individuals or Association of Persons
6 Father's Name (Only 'Individual' applicants: Even married women should fill in father's name only)
Last Name / Surname
First Name
Middle Name
7 Address
Residence Address
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub- Division
Town / City / District
State / Union Territory Pincode / Zip code Country Name
Office Address
Name of office
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Area code AO type Range code AO No.
Day Month Year
Sign/ Left Thumb impression
across this photo

Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub- Division
Town / City / District
State / Union Territory Pincode / Zip code Country Name
8 Address for Communication Residence Office (Please tick as applicable)
9 Telephone Number & Email ID details
Country code Area / STD Code Telephone / Mobile number
Email ID
10 Status of applicant
Please select status, as applicable Government
Individual Hindu undivided family Company Partnership Firm Association of Persons
Trusts Body of Individuals Local Authority Artificial Juridical Persons Limited Liability Partnership
11 Registration Number (for company, firms, etc.)
12. Country of Citizenship ISD Code of the Country of Citizenship
13 Source of Income Please select status, as applicable
Salary Capital Gains
Income from Business / Profession Business/Profession code [For Code: Refer instructions] Income from Other sources
Income from House property No income
14 Representative or Agent of the Applicant in India
Full Name (Full expanded name: initials are not permitted)
Please select title, as applicable Shri/Mr Smt/Mrs Kumari/Ms M/s
Last Name / Surname
First Name
Middle Name
Address
Flat/Room/ Door / Block No.
Name of Premises/ Building/ Village
Road/Street/ Lane/Post Office
Area / Locality / Taluka/ Sub- Division
Town / City / District
State / Union Territory Pincode / Zip code
15 Documents submitted as Proof of Identity(POI) and Proof of Address (POA)
I/We have enclosed as proof of identity, as
proof of address, and as mandatory certified documents
[Please refer to the instructions (as specified in Rule 114 of I.T. Rules, 1962) for list of mandatory certified documents to be submitted as applicable]
16 KYC details* [To be filled in by Foreign Institutional Investor or a Qualified Foreign Investor, as prescribed under the regulations issued by
the Securities and Exchange Board of India (SEBI)
[ "Control" as defined under SEBI (Substantial Acquisition of Shares and Takeovers) Regulations,1997
" Beneficial owner" as defined in the para 5.1 of SEBI circular dated December 31, 2010 on Anti Money Laundering.]
Full name, address of the Representative or Agent
[Annexure 1 to be used wherever applicable]
(a) In case of Individuals Please select as applicable
Marital Status Single Married Divorced Widow/Widower
Citizenship Status I Foreigner P Person of Indian origin O Overseas citizen of India
In case of Foreigner, country of Citizenship
Occupation details Private sector service Public sector/Govt. service Business Professional
Agriculturist Retired Housewife Student Others
(b) In case of non individuals Please select as applicable
R Private Company U Public Company D Body Corporate
S Financial Institution N Non Government Organization C Charitable Organization
( c) Gross Annual Income - INR
Netwoth (Assets less liabilities) in INR
(d) In case of a Public Company, whether listed on a stock exchange Yes No Please select as applicable
If yes, then indicate name of the stock exchange
(e) In case of Non-individuals
Does it have few persons or persons of the same family holding beneficial ownership and control.
Yes No Please select as applicable
["Control" :Control shall include the right to appoint majority of the directors or to control the management or policy decisons exercisable
by a person or persons acting individually or in concert, directly or indirectly, including by virtue of their shareholding or management
rigths or shareholders agreements or voting agreements or in any other manner
"Beneficial owner" means the natural person who ultimately owns or controls the applicant and/or the person on whose behalf a transaction
is being conducted, and includes a person who exercises ultimate effective control over a juridical person]
(f) Is the entity involved / providing any of the following services Please select as applicable
Foreign exchange, Money Changer Services Yes No
Gaming/Gambling/Lottery services (Casinos and Betting Syndicates) Yes No
Money Lending, Pawning Yes No
(g) Whether the applicant or the applicant's authorised signatories/trustees/office bearers is
(i) a politically exposed person Yes No
(ii) related to a politically exposed person Yes No
[For definition of politically exposed person refer to guidelines issued under the Prevention of Money Laundering Act (PMLA)]
(h) Taxpayer identification Number in the country of residence
17 I/We , the applicant, in the capacity of
do hereby declare that what is stated above is true to the best of my/our information and belief.
Place
D D M M Y Y Y Y
Date
Signature / Left Thumb Impression of
Applicant (inside the box)

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